Auricular acupressure for cancer-related fatigue during lung cancer chemotherapy: a randomised trial

BMJ Support Palliat Care. 2021 Mar;11(1):32-39. doi: 10.1136/bmjspcare-2019-001937. Epub 2019 Dec 13.


Purpose: To evaluate the effect of auricular acupressure (AA) on cancer-related fatigue (CRF), sleep disturbance and anxiety in lung cancer patients undergoing chemotherapy.

Materials and methods: Patients were recruited from the respiratory department of a general hospital and were randomised into three groups. A 9-week course of AA using Semen Vaccariae (SV) (Group A)/AA using magnetic beads (Group B)/routine care (Group C) was implemented. CRF scores were used as the primary outcome while the sleep and anxiety scores were the secondary outcomes. Analysis of variance and least significant difference t-test were used to determine the intergroup differences and paired-sample t-test was used for the intragroup comparison.

Results: 100 lung cancer patients undergoing chemotherapy were included. Compared with Group C, AA could significantly alleviate CRF (F:24.63, p<0.01), especially for physical and affective fatigue and Group A was more effective for managing physical fatigue than Group B in per-protocol (PP) (-1.75 (-2.69 to -0.82), p<0.01)/Intention to Treat analysis (ITT) (-1.41 (-2.39 to -0.41), p=0.01) analysis. However, AA had no effect on cognitive fatigue. Compared with Group C, only Group A produced significant improvements in sleep quality in PP analysis (-1.17 (-2.23 to -0.10), p=0.03) while it yielded negative results in ITT analysis (-0.82 (-1.74 to 0.10), p=0.08). Compared with Group C, AA could significantly reduce anxiety in PP analysis (F:9.35, p<0.01) while there was no statistical difference between Group B and Group C (-0.95 (-2.81 to 0.90), p=0.31), Group A and Group B (-1.26 (-3.12 to 0.59), p=0.18) in ITT analysis.

Conclusion: AA can alleviate CRF of lung cancer patients undergoing chemotherapy, especially for physical and affective fatigue. AA using SV is more effective for physical fatigue while AA using magnetic beads works better for anxiety. However, AA cannot improve the sleep quality.

Trial registration number: ISRCTNregistry (ISRCTN16408424).

Keywords: anxiety; auricular acupressure; cancer-related fatigue; lung cancer; sleep disturbance.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acupressure / methods*
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Anxiety / etiology
  • Anxiety / therapy
  • Auriculotherapy / methods*
  • Fatigue / etiology
  • Fatigue / therapy*
  • Female
  • Humans
  • Lung Neoplasms / complications*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / psychology
  • Male
  • Middle Aged
  • Sleep
  • Sleep Wake Disorders / etiology
  • Sleep Wake Disorders / therapy
  • Treatment Outcome